Nigeria's Owo – Victory Ovuoreoyen believed his life was over when he discovered he had the Lassa virus. When the craftsman was brought to the Federal Medical Center in the southwestern Nigerian city of Owo, he could hardly move and was terrified for his life. He had terrible diarrhea, a fever, and was throwing up.
The emaciated patient is now able to sit upright on his hospital bed after spending four days in an isolation unit, making him one of the few in the hospital who is strong enough to talk. "I couldn't count my bones like this before I got sick. He declares, pointing to his bulging clavicles under his baggy mustard-colored shirt, "I shed so much weight.
Acute hemorrhagic disease akin to Ebola, doctors have promised the 48-year-old guy that he will recover from the condition. He is blessed. According to the World Health Organization, the fatality rate among those who end up in the hospital is 15%, even though 80% of those who are infected do not experience severe symptoms from the virus and the majority of cases go untreated. After an incubation period of two to 21 days, acute symptoms may begin to manifest a week after the sickness has begun. It might be too late by then.
Internal bleeding results from lassa fever's reduction of the blood's platelet count and clotting capacity. Organ failure that is fatal may occur shortly after.
Early signs include fever, nausea, sore throat, headaches, and muscle aches. They initially resemble the signs of malaria, a prevalent illness in the area, and are difficult to recognize. The Lassa diagnostic blood tests are only performed in this hospital's laboratory in Owo, and the findings are only accessible after two days. This confluence of variables frequently causes Lassa to be diagnosed at a late stage, which makes treatment more challenging.
The epicenter of the Lassa outbreak, which started early this year and resulted in more than 160 deaths, is Owo, an agricultural market hub 300 kilometers (186 miles) from Abuja, the capital of Nigeria. The 38 beds in the isolation unit were not enough when it was at its busiest in March, so 10 additional cots were added for suspected patients. The Lassa virus is much more feared in this region of Nigeria than the coronavirus. With good reason: The Infection Control and Research Centre at the hospital reports that since 2020, 171 deaths in Ondo, the state where Owo is located, have been attributed to Lassa, as opposed to 85 deaths attributed to COVID-19.It's really contagious,
The intravenous drip that delivers Ovuoreoyen's antiviral medication and manages dehydration, a problem that seriously ill Lassa fever patients must contend with, is observed by head nurse Josephine Funmilola Alabi. Alabi is wearing a surgical cap, hazmat suit, face mask, and face shield. She is only permitted to enter the "red zone," the isolation ward for patients who are highly contagious, when she is clothed in this manner. She also has two sets of surgical gloves on and cleaned rubber boots. Not a single hair of her skin is exposed. We are quite concerned about this infection. According to Alabi, who is referring to the personal protective equipment that medical professionals who treat patients with extremely contagious diseases wear, we are only permitted to enter the ward while wearing full PPE. Medical professionals made up four of the Lassa deaths in Nigeria this year.The disease is still mostly unknown worldwide, despite being common in West Africa. About 1,000 kilometers (621 miles) from Owo in northern Nigeria, near the town of Lassa, the virus was found. Since then, it has spread over at least five West African nations. Nigeria, the most populated country in Africa, records the most cases—up to 1,000 each year. Nigeria reported 211 confirmed cases in January of this year, 40 of which were fatal.
According to the Africa Centres for Disease Control and Prevention, lassa fever affects 100,000 to 300,000 Africans annually, killing thousands of them.Body secretions from infected people can spread the disease to others. The fever can spread from moms to newborns and frequently results in miscarriages. It can last for up to six months in breast milk. Scientists have expressed concern that the Lassa virus could be used as a biological weapon, similar to other viruses that cause haemorrhagic fevers that have no known cure and are simple to reproduce."Diseases have no limits,"
Poor rural communities are more likely to have the fever, and food tainted with rat waste or urine is frequently the source of infection. Bushmeat, or roasted game, may also be contaminated if the killed animal came into touch with rodents. When the rains stop, the rats frequently break into homes in quest of food. Because of this, although there are instances year-round, Lassa fever normally peaks in Nigeria's dry season, from November to April.
Clinical microbiologist Adebola Olayinka claims that it is not dispersing as quickly as COVID-19 did. But she says that could change. She oversees the Nigeria Centre for Disease Control's study on Lassa fever and is an expert in infectious hazardous diseases. Look at the Ebola story, she advises. This had been present in the Democratic Republic of the Congo for years before spreading fast to West Africa in 2014, followed by England and the US.Olayinka claims there are no effective treatments or vaccines to prevent Lassa disease. Ribavirin, an antiviral medication frequently used to treat Hepatitis C, is the only pharmaceutical now used to treat Lassa fever. Pre-clinical investigations and pricey clinical trials are required to demonstrate the drug's efficacy against the Lassa virus, however, as this has not been properly investigated. She thinks the lack of Lassa study is a result of how infrequently it strikes Westerners.
"Look at how quickly the COVID vaccine was developed," she remarks. However, an infectious disease won't receive as much attention if it doesn't harm the wealthy. The Access to Medicine Index created a list of the 20 biggest pharmaceutical companies' research and development activities one year following the pandemic's outbreak in 2020. It detected 63 coronavirus-related projects, five Ebola-related initiatives, and 0 hemorrhagic virus projects—mostly prevalent in Africa and Latin America—that are carried by rodents like Lassa.
But Lassa can still harm the West. A couple in England received the diagnosis earlier this year. During a trip to Mali, the husband caught it, infecting his expectant wife. In a hospital in Bedfordshire, their preterm infant perished from the infection. Olayinka cautions, "The West needs to understand that a disease anyplace could be a disease everywhere." "Diseases have no borders."
‘They caught it on time’
In Owo, head nurse Alabi continues her rounds. On this particular day in April, 20 of the 38 beds are filled. This is the only treatment centre for Lassa fever in Ondo, a state half the size of Belgium with about 3.5 million inhabitants. A month earlier the ward was filled to the brim. And a couple of years ago so many people were infected that tents for patients were put up on the open grounds next to the bungalow where the Lassa ward is located.
Alabi asks patients how they are doing and checks an intravenous (IV) drip here and there. Apart from anti-viral drugs, patients also are treated with vitamins, antibiotics for additional bacteria infections and malaria medications if they also test positive for that disease. The staff is not supposed to stay in the “red” isolation zone for more than an hour at a stretch, to limit the risk of infection. But during an outbreak such as this year’s, doing rounds in an overcrowded ward can take two hours. “It is a risk you take, for the sake of the patients,” she says matter-of-factly.
Hospital beds with chipped enamel bars line the corridors of the “red zone”. IV bags hang next to the cots. Alabi explains that the patients lie in the hallway so that the staff can hear them when they weakly call for help. Disinfecting the medical staff’s protective boots and face shields occurs around the clock. Used gear goes into large vats of chlorinated water and is then put on wooden stands to dry in the tropical sun.They arrived in time.
Alabi, the head nurse, is still doing the rounds at Owo. Twenty of the available 38 beds are full on this particular day in April. In Ondo, a state with 3.5 million residents that is half the size of Belgium, this is the only facility for treating Lassa fever. The ward was completely full a month before. And a few years ago, there were so many cases of the disease that tents for patients had to be set up on the grassy area next to the cottage where the Lassa unit is housed.
Alabi checks an IV drip occasionally and inquires about the patients' well-being. In addition to antiviral medications, patients receive vitamin therapy, antibiotics for bacterial infections, and, if a malaria test is positive, treatments. To reduce the danger of infection, the staff is not permitted to remain in the "red" isolation zone for longer than an hour at a time. However, doing the rounds in a congested hospital can take two hours during an outbreak like the one this year. She explains matter-of-factly, "It is a risk you accept, for the sake of the patients.
The hallways of the "red zone" are lined with hospital beds with broken enamel bars. Infusion bag hangs close to the cots. According to Alabi, the patients lie in the corridor so that the staff may hear their shaky cries for assistance. The face shields and protective boots worn by the medical staff are cleaned continuously. In order to dry in the tropical sun, used equipment is placed on wooden supports and submerged in big vats of chlorinated water.Dr. Sampson Omagbemi Owhin is having a conversation with a patient named Olaide Akinyola around the corner under the marquee that covers the walkway leading to the clinic's entrance. They talk about her rehabilitation while outside, seated on plastic chairs.
Primary school teacher Akinyola, 38, visited the Lassa ward once more this morning for a checkup. After experiencing some health issues for a few days, she was admitted to the treatment facility a month and a half ago. She initially believed the bleeding to be the result of a strong menstrual flow, but after becoming too faint to stand up straight, she had a test for Lassa. After getting a positive result, she was brought into the clinic right away.
According to her doctor, Akinyola was lucky because "they caught it on time." She underwent a blood transfusion and was given ribavirin treatment, which in this instance seemed to be beneficial.Knowledge is a weapon.
Akinyola claims that because she is a teacher, she has simple access to knowledge regarding the virus. She says, "That's why I wasn't too afraid when I was admitted here. "Since they discovered the virus quickly, I believed my odds were strong."
Her doctor believes that knowledge is a crucial tool in the fight against Lassa fever. A patient may experience bleeding for a long time even after being released from the hospital's ward. The virus has been discovered in semen two years after being discovered in blood, according to hematologist Ohwin, which is why recovered male patients are urged to use condoms during intercourse.
Later on same day, 42-year-old Kayode Omolayo makes his way to the visitors' area, a concrete floor covered by an orange aluminum roof shelter, from the Lassa clinic's patient exit. A trench divides the platform below, dividing the sick from the healthy. Visitors are directed to the fenced-off area by a metal sign on the grass where they can safely greet the sick who have recovered enough to get out of bed.Omolayo is well aware of the need of maintaining cleanliness at home after spending 10 days in the Lassa department. She declares, "The first thing I'll do is clean everything thoroughly and look for rat droppings."
Head nurse Alabi exits the red zone at the Lassa ward and enters the station where protective gear is removed and re-used shoes and face shields are cleaned in plastic barrels. The 50-year-old expresses her worries about the future as she slowly peels back the layers.
The nurse claims that it is getting harder for NGOs working to combat diseases like Lassa fever to raise money. This implies that there will be less bottled water available for the crew to drink after working in sweaty moon suits. The pace of personal protective equipment distribution is decreasing. She worries that the medical center may run out of money if it continues to provide the current free care because the majority of Nigerians cannot pay the $1,000 cost of treatment.
The crew is preparing for a new wave in the interim. Alabi's smile fades as she says seriously, "The next deadly Lassa outbreak is only a matter of time," while squinting through her rectangular glasses.
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